Repealing Obamacare, state by state

BY TIM PAWLENTY,

THURSDAY, NOVEMBER 18, 2010

After a historic election reflecting six in ten voters wanting to repeal Obamacare, the question now facing conservatives is how.

As long as President Barack Obama holds his veto pen, undoing this misguided piece of legislation will not be easy. But we can make progress. While Congress takes important steps toward eventual repeal, governors can use their authority to stop or delay implementation of Obamacare. It must be fought not only in Washington but in state capitols.

In Minnesota, I issued an executive order directing state agencies to reject participation in Obamacare unless required by law or consistent with existing state policy. I also joined the federal lawsuit that challenges Obamacare’s individual mandate and invokes the 10th Amendment in defense of states’ rights and a proper view of federalism. Newly elected Republican governors should consider taking similar actions.

Fighting Obamacare, however, is not enough. Merely restoring the status quo of skyrocketing costs, narrowing access, and structural dysfunction would be a mistake. Our health care system needs to be more effective and affordable. Reforms should feature timeless conservative principles applied to the challenges and opportunities of our time.

The great tragedy of Obamacare is not only that we know it will fail, but that we have not implemented health care reforms that we know will succeed.

In recent years, Minnesotans have embraced innovative, conservative health care reform. We focused on improving quality and containing cost, not just expanded access. We made it easier for consumers to use HSA plans (Minnesota is second in the nation on HSAs). We provided online cost and quality information for the 100 most common health services. We passed tort reform to curb frivolous lawsuits. And we engaged the private sector as a partner, not as an opponent.

Today, Minnesotans enjoy one of the finest health care systems in the country. We continue to have some of the healthiest people in the nation and one of the lowest rates of uninsured. We have learned through trial and error what works, and we know what doesn’t.

We know that we need to give people more power over the use of their health care dollars and decisions. Today, six of every seven health care dollars is spent by someone other than the person receiving the care. Health care today is like an open bar. When someone else is paying the bill, people behave differently. For decades, this open bar approach has encouraged wasteful spending by individuals and providers rather than a sober assessment of costs and benefits. But our struggling economy and deficit-ridden budgets are flashing warning lights that closing time is near.

Obamacare was a missed opportunity to fix this systemic problem and the new law only made matters worse by taking control away from people. In fact, the new law allows the government to eventually control over half of all health care spending. True reform must turn our government-run system right side up, giving patients control over their health care dollars and decisions, while subjecting providers and insurers to the competitive forces of a real market.

Giving Americans more choice, ownership and responsibility will bring about greater efficiency and lower costs. Making this shift from the government to purchasers will not happen overnight, but here are some ideas for Congress to get us moving in the right direction.

Congress should change the tax code to end the bias against people who purchase their own health insurance. People who buy insurance through their employer get a tax break on the value of the benefits. Individual and group purchasers should be treated the same.

Congress should allow individuals to shop across state lines for health insurance. Doing so would dramatically increase insurance choices and cut costs through better competition.

Most importantly, Congress should back off and give the states latitude. If states can demonstrate a better way to reach policy goals, Congress should permit states to do what works best. A one-size-fits-all approach has not and will never work in a country as diverse as ours. This is what federalism is all about.

Obamacare is one of the most misguided pieces of legislation in the modern history of our country. A 2,000-page, trillion-dollar, politically driven takeover of one-sixth of our economy, Obamacare is both too complicated to succeed and too broken to repair. Voters this year sent a strong message that they want it stopped. The newly elected Republican governors gathering in San Diego this week have an opportunity to do just that.

Pawlenty is in his second term as governor of Minnesota. He is vice chair of the Republican Governors Association, which is meeting this week in San Diego